HomeMy WebLinkAboutLA108244 PERMIT
City of Lakeville Permit Type: Building
20195 F~olyoke Ave Permit Number: LA108244
Lakeville, MN 55044
(952) 985-4440 * L R 1 B z 4 4
www.ci.lakeville.mn.us Date Issued: 09/26/2008
Site Address: 17295 Finch Path
Lot: 013 Block: 002 Addition: Dodd Ridge 3rd Addition
PID: 22-20877-130-02
.Use: * 2 2 -2 QJ 8 7 7- 1 3 -0 2
Description:
Sub Type: Reroof Construction Type:
Work Type: Replace
Description: Applicant must call for inspection.
Census Code: - Occupancy:
Zoning:
Square Feet: 0
Comments:
Fee Summary: Description Amount Revenue Code
Res Reroof/Reside/ Windows $39.50 1000-4151
Surcharge (.50) $0.50 .1000-2127
Total: $40.00
Contractor: Owner: -Applicant -
Steven Kallevig
17295 Finch Path
Farmington MN 55024
I HEREBY AGREE THAT THIS WORK WILL BE PERFORMED ACCORDING TO: (1) THE APPROVED PLANS &
SPECIFICATIONS; (2) THE APPLICABLE CITY ORDINANCES & CODES; AND (3) THE MN STATE BUILDING CODE.
Applicant/rermitee: Signature Issued Ey: Signature
RESIDENTIAL BUILDING Office use only
PERMIT APPLICATION ~~g°
~ " ~ Permit Num er
J~ CITY OF LAKEVILLE
~ BUILDING INSPECTIONS DEPARTMENT Received By
w'~'~^"" .20195 HOLYOKE AVENUE
,i LAKEVILLE, MN 55044
952-985-4440 Date Received
www.ci.lakeville. mn. us
Fee Total
SITE ADDRESS: ~ tr
MAILING ADDRESS: CITY: ~~@+v t I ~e, STATE:~_ ZIP: S J ~y~
JOB DESCRIPTION: ~20~ T
ESTIMATED VALUATION: PROPOSED START DATE: ~ END DATE: ~ -a~
(New Residential Only): LEGAL DESCRIPTION: LOT: BLOCK: SUBDIVISION:
APPLICANT IS: j~~ESIDENT OWNER ? CONTRACTOR
NEW MODEL HOME: YES ~NO IF YES -ADMINISTRATIVE PERMIT REQUIRED ISD #
PLEASE//'~~FILL OUT THEiiFOLLOWING COMPLETELY
NAME; l,@ ~ ~'1•l~'- ~al'e Cl - ~uniE'y"
RESIDENT OWNER
HOME PHONE CELL PHONE:
GENERAL CONTRACTOR CONTRACTOR: LICENSE BC
? Homeowner OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
ELECTRICAL WORK CONTRACTOR: LICENSE CA
? Homeowner * OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
Single Meter on individual unit Meter Bank at end of building (Requires licensed electrician.)
PLUMBING WORK CONTRACTOR: LICENSE PM
? Homeowner OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
MECHANICAL WORK CONTRACTOR:
? Homeowner OFFICE PHONE CELL PHONE:
? Contractor ADDRESS: CITY: ST: ZIP:
SEWER/WATER CONTRACTOR NAME:
New Construction Only .HOME PHONE CELL PHONE:
INTEREST EARNINGS ON THE ESCROW ACCOUNTS, IF ANY, ARE RETAINED BY THE CITY TO OFFSET THE
ADMINISTRATIVE COSTS ASSOCIATED WITH PROCESSING THE ESCROW APPLICATION AND REFUND. I HEREBY
APPLY FOR A BUILDING .PERMIT AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND
ACCURATE; THAT THE WORK WILL B IN CONFORMANCE WITH THE ORDINANCES AND CODES OF THE CITY AND
WITHT THE STATE BUILDING CODE, THAT I UNDERSTAND THIS IS NOT A PERMIT AND WORK IS NOT TO START
WITHOUT. A PERMIT AND THAT THE WORK WILL BE IN ACCORDANCE WITH THE APPROVED PLAN
NAME OF APPLICANT (Please Print) DATE ~ ~
APPLICANT'S SIGNATURE:
RESIDENTIAL BUILDING PERMIT APPLICATION PAGE 2,
OFFICE USE ONLY
BUILDING PERMIT TYPE REQUIRED INSPECTIONS
SINGLE FAMILY DWELLING BUILDING
.DUPLEX FOOTING
TOWNHOUSE UNITS POURED WALL
DETACHED TOWNHOUSE UNIT GARAGES
CONDO FOUNDATION
ACCESSORY BUILDING FRAMING
~REROOF LATH
RESIDE FIREPLACE
RES ADDN/REAIR/RMDL INSULATION
DECK DECK FOOTING
PORCH PORCH FOOTING
LOWER LEVEL FINISH BUILDING FINAL
ADDITION LOWER LEVEL FRAME
FOUNDATION ONLY SITE
MISCELLANEOUS OTHER
UNDEFINED WELL SEAL
DEMO SEPTIC TANK REMOVAL
MOVED
$ ELECTRICAL
CITY BUILDING VALUATION ROUGH-IN
TRENCH
BUILDING PERMIT FEES FINpI,
$ PERMIT FEE MECHANICAL
$ PLAN CHECK ROUGH-IN
$ SURCHARGE AIR TEST
$ METRO SAC FINAL
$ CITY WATER HOOKUP UNIT PLUMBING
$ CITY SEWER HOOKUP UNIT ROUGH-IN
$ LANDSCAPE ESCROW FINAL
$ TREE ESCROW METER SIZE
$ MISC ESCROW PRESSURE REDUCING VALVE
$ ELECTRICAL SEWER AND WATER
$ PLUMBING FINAL
$ MECHANICAL STREET DRAINTILE
$ SEWER & WATER
$ OTHER BUILDING INFORMATION
U~ TYPE OF CONSTRUCTION
$ ~ TOTAL ZONING
CODE EDITION
APPROVED BY: FIRE SUPPRESSION SYSTEM
OCCUPANCY GROUP
BUILDING INSPECTOR: ~ DATE:_ ~2 ~ -Q`$~
PLUMBING/MECHANICAL INSPECTOR: DATE:
COMMENTS:
(Revised 03/26/2007)